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Updated: May 8, 2026
23:33
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
83.6K
Prognostic Impact of Left Atrial Appendage Patency After Device Closure
Mu Chen1, Peng-Cheng Yao1, Zhen-Tao Fei1
1Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, China.
Circulation. Cardiovascular Interventions
|April 17, 2024
Summary
Left atrial appendage (LAA) patency after WATCHMAN device closure increases stroke risk in atrial fibrillation patients. Even small leaks impact prognosis, highlighting the need for careful monitoring and management.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Procedures
Background:
- Prognostic impact of left atrial appendage (LAA) patency post-LAA closure in atrial fibrillation (AF) patients is not fully understood.
- Visible peri-device leak (PDL) is a known complication, but its significance alongside LAA patency requires further investigation.
Purpose of the Study:
- To evaluate the prognostic significance of LAA patency, with or without PDL, after WATCHMAN 2.5 device implantation in AF patients.
- To identify risk factors associated with adverse events in patients with LAA patency.
Main Methods:
- Prospective enrollment of 519 AF patients receiving WATCHMAN 2.5 device.
- Cardiac computed tomography angiography (CCTA) at 3 months for LAA surveillance.
- Comparison of adverse events (stroke/TIA, bleeding, death, MAEs) between complete closure and LAA patency groups.
Main Results:
- LAA patency observed in 47.8% of patients (37.8% with PDL, 10.0% without).
- LAA patency significantly increased risks of stroke/TIA (aHR 3.22) and MAEs (aHR 1.12).
- Increased PDL size correlated with higher incidences of stroke/TIA, cardiovascular death, and MAEs.
Conclusions:
- LAA patency detected by CCTA at 3 months post-closure is linked to poorer outcomes in AF patients with WATCHMAN devices.
- Visible PDL, regardless of size, is associated with increased stroke/TIA and MAE risks.
- Older age and cessation of antiplatelet therapy predict adverse events in patients with LAA patency.
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